Study On Adaptability Of Elderly Hemodialysis Patients Under The Perspective Of Roy Adaptation Mode

At present,there are more and more patients with chronic kidney disease.As China has been gradually gaining access to the aging society,elderly hemodialysis patients base is bound to increase.Maintenance hemodialysis is the main treatment for patients with end stage renal disease to postpone the development of disease and prolong life.Hemodialysis is lifelong and complexity,which makes the patients suffer from long disease and treatment.As the health view changes from a single dimension of physical health to a multi-dimension of “physiological-psychological-societal”,the treatments aim to improve and restore the patient's physiological,psychological and social function,instead of life subsisting and symptoms relieving only,where the adaptation in hemodialysis patients in the course of the treatments is one of the key indicators.Therefore,how to assist elderly hemodialysis patients to adapt to hemodialysis effectively is an issue that must be concerned and considered.Under the guidance of Roy adaptation model and ecosystem theory,this qualitative study was meant to describe and analyze the adaptation links of the patients,such as focal stimuli,adaptation and influencing factors in regulation processes.The patients in in blood dialysis room of H Hospital were using as an entry point in this study,where medical social worker were early in.The study found that the elderly patients with the big stimuli,which means they need undergo lifelong hemodialysis to maintain their life,fail to adapt to this situation in many aspects,such as their physiological functions,self-concepts,role functions and interdependence,while microcosmic,middle and macroscopic ecosystem factors affect their regulatory processes in varied degrees.Furthermore,based on the development and background of social worker services in Guangzhou,combined with the guidance of ecosystem theory,this paper explores the professional medical social worker services strategies for elderly hemodialysis patients,and proposes that medical social workers should pay attention to the following three aspects in practical interventions for the adaptation of elderly patients with hemodialysis: systematization of service perspectives,diversification of service roles,and coordination services,especially the positive interaction between various factors of the patient's “community-hospital” system,as well as focus on the collaborative services of medical social workers and social workers in Family integrated service center,in order to provide reference to the treatments and services developments of the elderly hemodialysis patients in China.